Thousands of civilians have already fallen victim to the war in Ukraine. The hospitals in the east of the country are under great pressure. For the doctors, the work is an enormous physical and emotional burden.

Russia’s invasion of Ukraine claims huge civilian casualties. The armed forces of Kremlin chief Vladimir Putin are firing rockets and artillery at residential buildings, schools, hospitals and train stations, sometimes reducing entire districts or towns to rubble. They also use cluster munitions, which are banned under the 2010 Oslo Convention — which Russia has not signed — due to their particular danger to the civilian population. According to a count by the United Nations High Commissioner for Human Rights, since the start of the Russian invasion on February 24 up to and including May 30, 4,113 civilians have been killed and 4,916 injured. However, the Commissariat assumes that the actual numbers are significantly higher.

Clinics in eastern Ukraine under severe pressure

The international aid organization Médecins Sans Frontières (Doctors Without Borders) is also involved in caring for the injured. With the help of a specially equipped train, which even has an intensive care unit, MLF workers bring the wounded from the embattled areas of eastern Ukraine to the safer west of the country for treatment.

Since the beginning of the war, hospitals in the east have been under severe pressure, MSF evacuation train coordinator Yasser Kamaledin told the Associated Press. “The idea of ​​this action is to support the hospitals that are closer to the frontline and free up bed capacity so that they can accommodate more patients affected by the attacks, the conflict, but also other chronically ill patients.” Almost 600 people have been taken to hospitals in western Ukraine since the train journeys started on March 31.

One of the evacuees is Mykola Pastukh. He was wounded by a mortar shell near Sieverodonetsk last Saturday while trying to bring humanitarian aid to the war-torn city, the AP reports. Shrapnel was still lodged in his body, the 40-year-old — his right arm in a sling — told the news outlet. He had to be operated on, but the hospital in the neighboring town of Lyssychansk, which was also contested, was simply overwhelmed. So he will be taken to Lviv in western Ukraine for the operation.

The pressure on hospitals in the east is most evident immediately after an attack, when one injured person after another is brought in, the AP writes. Last week, paramedics brought a patient with a serious head injury to the Pokrovsk city hospital, while the doctors there were already tensely tending to the patients injured in the impact of two rockets. There were only a handful of injuries, but the hospital is overwhelmed and only working with about half the previous staff. And that in rooms where sandbags were stacked in front of boarded-up windows.

Before the war, “when there was still normal work, we had ten surgeons, now there are five,” AP quotes doctor Ivan Mozhaiev as saying. In his department, the 32-year-old is the only surgeon left of the five.

“Now we have to treat people with gunshot wounds”

Mozhaiev’s colleague Viktor Krikliy, head of surgery at a hospital in Kramatorsk in the Donetsk region, reports something similar: Many employees of the clinic had to leave the city and close several departments, while the people from Kramatorsk and the surrounding areas still had to be cared for, he says the news agency. There are two surgical departments in his area, each of which used to have 15 surgeons. Now there are only six surgeons for both departments. The same applies to nurses, whose workforce is only about half what it was before the war.

But not only the quantity, but also the type of work and the patients have radically changed with the war. “We used to treat people with illnesses, sometimes there was also trauma. Now we have to treat people with gunshot wounds,” reports Krikliy.

The Kramatorsk hospital has dealt with war injuries before, according to the AP. The city is located in Donbas, where Russian-backed separatists started fighting Ukrainian forces in 2014, and even then Krikliy had to operate on the wounded. “But the extent now and then is incomparable,” says the doctor. And it is the first time that the medical staff in Kramatorsk are treating many wounded civilians instead of soldiers.

“We never dreamed, even in the most horrible nightmare, that civilians in Ukraine would suffer such injuries,” says Krikliy. He had to operate on small children whose limbs had been blown off by explosions.

But despite the danger and the physical and emotional strain, the doctor wants to stay. We are surgeons. Our job is to operate on people and treat them. If everyone leaves, who’s going to do the work,” says Krikliy. “We’re not a suicide squad and we’re not looking for a way to die anywhere. But… we do our job. And we will continue to do so.”

Sources: UN High Commissioner for Human Rights, Associated Press, Human Rights Watch, Federal Foreign Office